| NPI | 1023511987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 326440) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207X00000X Orthopaedic Surgery (Licence: PA OT018338) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2024-08-01 |